Actos: Effective Type 2 Diabetes Glucose Control Medication
| Product dosage: 15mg | |||
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| Product dosage: 30mg | |||
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Synonyms | |||
Similar products
Actos (pioglitazone hydrochloride) is a thiazolidinedione-class oral antidiabetic agent indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It functions as an insulin sensitizer, targeting insulin resistance in peripheral tissues. By activating peroxisome proliferator-activated receptor-gamma (PPAR-γ), it enhances cellular response to endogenous insulin, thereby reducing hepatic glucose output and improving glucose utilization in skeletal muscle. This medication is designed for long-term management and is often used in combination with other antidiabetic agents when monotherapy does not provide adequate glycemic control.
Features
- Contains pioglitazone hydrochloride as the active pharmaceutical ingredient
- Available in 15 mg, 30 mg, and 45 mg film-coated tablets
- Oral administration, once daily dosing
- Prescription-only medication
- Manufactured under strict pharmaceutical quality control standards
- Requires regular blood glucose monitoring during therapy
Benefits
- Significantly reduces HbA1c levels, supporting long-term glycemic targets
- Decreases insulin resistance, a core pathophysiological defect in type 2 diabetes
- May improve lipid profiles by reducing triglycerides and increasing HDL cholesterol
- Provides sustained 24-hour glycemic control with once-daily dosing
- Can be used as monotherapy or in combination with other antidiabetic agents
- Does not cause hypoglycemia when used as monotherapy
Common use
Actos is primarily prescribed for the management of type 2 diabetes mellitus in adults. It is typically initiated when lifestyle modifications (diet and exercise) alone prove insufficient for achieving target glycemic levels. The medication may be used as monotherapy or in combination with other oral antidiabetic agents including metformin, sulfonylureas, or insulin when additional glycemic control is required. Clinical studies have demonstrated its effectiveness in reducing fasting plasma glucose and postprandial glucose levels while improving beta-cell function.
Dosage and direction
The recommended starting dose is 15 mg or 30 mg once daily, which may be increased to a maximum of 45 mg once daily based on glycemic response as measured by HbA1c levels. Dosage adjustments should be made gradually, typically at intervals of no less than 8-12 weeks, to adequately assess therapeutic response. Administration should occur with or without food, as food does not significantly affect absorption. Tablets should be swallowed whole with water and not crushed or divided. Liver function tests should be performed prior to initiation and periodically during treatment.
Precautions
Regular monitoring of liver enzymes is mandatory, with discontinuation if ALT levels exceed 2.5 times the upper limit of normal. Patients should be monitored for signs and symptoms of heart failure, as fluid retention may occur. Weight gain is common and should be anticipated. Regular ophthalmologic examinations are recommended due to potential risk of diabetic macular edema. Hemoglobin levels should be monitored periodically as slight decreases may occur. Not recommended for patients with NYHA Class III or IV cardiac status. Use with caution in patients with edema or history of heart failure.
Contraindications
Actos is contraindicated in patients with known hypersensitivity to pioglitazone or any component of the formulation. It must not be used in patients with established New York Heart Association (NYHA) Class III or IV heart failure. Contraindicated in patients with active liver disease or ALT levels >2.5 times the upper limit of normal. Not recommended for patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis. Should not be used in patients with bladder cancer or history of bladder cancer. Contraindicated in severe renal impairment (not recommended for use in end-stage renal disease requiring dialysis).
Possible side effects
Common adverse reactions (≥5%) include upper respiratory tract infection, headache, sinusitis, myalgia, tooth disorder, diabetes mellitus aggravated, and pharyngitis. Hypoglycemia may occur when used in combination with insulin or insulin secretagogues. Weight gain of 2-4 kg occurs in many patients. Edema and anemia have been reported. Less frequent but serious side effects include congestive heart failure, fractures (particularly in female patients), macular edema, and hepatic enzyme elevations. Rare cases of bladder cancer have been reported with long-term use.
Drug interaction
Strong CYP2C8 inhibitors (such as gemfibrozil) may significantly increase pioglitazone concentrations—dose reduction may be necessary. Inducers of CYP2C8 (such as rifampin) may decrease pioglitazone concentrations. Concomitant use with insulin or insulin secretagogues may increase the risk of hypoglycemia—dose reduction of these agents may be required. May decrease the efficacy of oral contraceptives—additional contraceptive methods should be considered. NSAIDs may enhance the fluid-retaining effects of pioglitazone.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is near the time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistent daily administration at approximately the same time each day is recommended for optimal glycemic control.
Overdose
Cases of overdose have been reported with doses up to 120 mg. Expected manifestations would include exaggerated pharmacological effects such as hypoglycemia (especially when used with other antidiabetic agents), fluid retention, and weight gain. There is no specific antidote for pioglitazone overdose. Treatment should be symptomatic and supportive, with appropriate monitoring of blood glucose levels and cardiac function. Hemodialysis is unlikely to be effective due to high protein binding.
Storage
Store at controlled room temperature 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not store in bathroom or other areas with high humidity.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Actos is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to therapy may vary. Patients should not initiate, adjust, or discontinue medication without consulting their physician. The complete prescribing information should be reviewed before initiating therapy.
Reviews
Clinical trials have demonstrated that Actos produces significant reductions in HbA1c (typically 0.5-1.5%) when used as monotherapy. Combination therapy studies show additional glycemic benefits when added to metformin, sulfonylureas, or insulin. Many endocrinologists note its particular effectiveness in insulin-resistant patients. Some clinicians express caution regarding the potential for fluid retention and weight gain. Long-term observational studies continue to evaluate the benefit-risk profile, particularly regarding cardiovascular outcomes and bladder cancer risk. Patient satisfaction often relates to the once-daily dosing convenience and avoidance of hypoglycemia when used as monotherapy.